Provider Demographics
NPI:1568808111
Name:SALAS, ANNIA
Entity type:Individual
Prefix:
First Name:ANNIA
Middle Name:
Last Name:SALAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 W 2ND PL
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-6410
Mailing Address - Country:US
Mailing Address - Phone:602-486-9172
Mailing Address - Fax:
Practice Address - Street 1:1440 E MISSOURI AVE STE C160
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2458
Practice Address - Country:US
Practice Address - Phone:602-878-8142
Practice Address - Fax:602-563-8150
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health